1stHealthSystems Releases Health Care Costs White Paper

BELLEVUE, Wash., Feb. 28, 2013 /PRNewswire/ -- 1stHealthSystems, provider of data-driven technology and analytics for hospital outpatient services coding, has released a new whitepaper titled "Billing and Payment for Hospital Emergency Department Encounters." The white paper investigates the changes in hospital ED visit charges, which have risen dramatically in recent decades, and the subsequent effects on hospitals and patients.

Hospital ED charges were once relatively simple, consistent, and much less than what they are today for the same services. In the past 30 years, ED charges have skyrocketed. In 2010, the average markup of visit charges was 400% to 500% more than the reported Medicare payment. Charging for services has also evolved into a complicated system and hospitals have recently come under scrutiny for their inconsistencies.

The white paper discusses the driving factors associated with new reimbursement policies that have contributed to the increased cost of health care services in the United States. Payments for these charges also vary widely depending on whether the patient is covered by Medicare/Medicaid, private insurance, or is uninsured.

In the white paper, 1stHealthSystems addresses these challenges with some key points to effectively manage charges and payments.

"Hospital charges for nearly all services and supplies are not linked to actual costs. Pricing for inpatient and outpatient services has trended up year over year at a hospital wide rate," said Dr. Mason Smith, 1stHealthSystems' Chief Executive Officer. "For many years, hospitals increased their billed charges by an average rate of 8 to 12% per year, and selected services were increased more than average to take advantage of insurance payment differences."